Contents

Terms of Use and Disclaimer 3

How to contact Mr. J aheed Khan 4
Forward 7
What patients & staff say about Mr. Khan 9
What exactly ARE cataracts? 11
What are the symptoms of cataracts? 13
What causes cataracts? 14
How are cataracts treated? 17
What can I expect during cataract surgery? 18
What happens after my operation? 21
Are there any risks to cataract surgery? 22
Frequently asked questions about cataract surgery 23
Afterword 25
How to contact Mr. J aheed Khan 26




Terms of Use and Disclaimer
his eBook is Copyright 2014. All rights are reserved. No
part of this book may be reproduced, stored in a retrieval
system or transmitted by any means: electronic,
mechanical or photocopied, recorded or otherwise without written
permission from the copyright holders.

You may distribute this eBook as long as it remains in its original
form and unchanged in content.

The authors are both qualified surgeons and Mr. J aheed Khan
has particular expertise in eye and cataract surgery.

Nevertheless this eBook is not intended to replace the need for a
one-on-one consultation with and examination by a qualified and
experienced ophthalmologist. All advice given is intended for
general guidance only.

If you have any disturbance in your vision or eyesight you are
advised to seek medically qualified advice without delay.

Emergency medical care can be obtained through your GP or
local Accident and Emergency Department.

Mr J aheed Khan can is also very happy to see patients both
NHS and Privately.

His contact details for patients who wish to consult him privately
are overleaf.

NHS patients will need to see their GP to be referred to him at
Moorfields Hospital.

T


How to Contact Mr. J aheed Khan
rivately I practice at both Moorfields and at Harley Street
either telephone or send my secretary an email. A GP referral
is not necessary for Private Patients.

Moorfields Eye Hospital



Private Consulting Rooms
J ohn Saunders Suite
9-11 Bath Street
London EC1V 9LF

Tel: (020) 7566 2803

enquiries@moorfields-private.co.uk











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P




Clinica London
140 Harley Street
London W1G 7LB

Tel: (020) 7935 7990
secretary@clinicalondon.co.uk


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Forward

Mr. J aheed Kahn,
Consultant Eye Surgeon.

y name is J aheed Khan, and I am an eye surgeon at the
world-famous Moorfields Eye Hospital in London.

I have almost twenty years experience as a doctor and fifteen
years experience as an eye surgeon. In that time if theres one
thing Ive learned its how vulnerable we all feel when we are
unwell.

And we feel no more vulnerable when the problem we have is
with our eyes.

Hospitals can be frightening places, and talking to doctors is not
always easy.

Which is why Ive written this eBook. It is the culmination of all
those years of experience in looking after patients and their eye
problems.

In it I cover all the basics: what cataracts are, how they cause
problems with your vision, and how they are treated. Theres no
jargon, only straightforward, simple, clear explanation and advice,
M


and I also answer the questions I get most commonly asked in my
clinics and wards in the hospital where I work every day.
If you have any feedback or want to ask any questions about
anything in this eBook, simply drop me an email via my secretary
at

secretary@clinicalondon.co.uk

I would be delighted to hear from you and will personally answer
your query.

With Best Wishes,


J aheed Khan
Consultant Ophthalmologist.

Moorfields Eye Hospital,
London.
May 2014.



What Patients and Staff Say About Mr. J aheed Khan
Mr Khan is not only an outstanding surgeon but more importantly a
great communicator and caring Doctor. As a GP and commissioner I
have total faith when referring my patients to Mr Khan,that they will
receive the best care available from a surgeon who constantly strives for
excellence and treats them as individuals. I would not hesitate to
recommend him to both my private and NHS patients. He is a real asset
to both Moorfields and Hinchingbrook Hospitals.
Mr Khan is a brilliant doctor and was a pleasure to work with.
J aheed Khan is a very competent Ophthalmologist with great patient
care skills and the unique ability to explain complex condition in a
manner comprehendible to the patient.
J ust keep up the good work Dr Khan. My wife, who accompanied me,
and I were both very impressed by the care and consideration shown by
the whole team when I had surgery. I just hope they haven't lost the
knack by the time I get my other eye fixed. J oking apart the care of this
team has made it a wonderful experience for me.
A knowledgable and trustworthy colleague with extensive experience
in the diagnosis and treatment of retinal diseases. Up to date with the
latest research and best practice, he is able to integrate this knowledge
into the care of patients with ophthalmic conditions. I would have no
hesitation in recommending him to friends and family.
Mr J aheed Khan is a thorough, compassionate and conscientious
doctor. He listens to his patients and treats them with respect and care.
He provides excellent medical care, both in clinic and in the operating
theatre. I would highly recommend him.
Mr Khan is an excellent colleague to work with. He is always
approachable and willing to help. His has an outstanding level of
knowledge concerning eye disease and he is more than happy to offer
his opinion whenever needed. He is trustworthy and respects both
patients and colleagues. I have no hesitation to state that he is one of
the best colleagues I worked with.
I always enjoy working with Mr Khan, he is friendly, confident and
approachable. He always maintains a high standard of professionalism


in sometimes testing situations. Mr Khan is always willing to answer
questions related to Ophthalmology that i may have and explains things
in a manner in which myself and other colleagues understand. He is a
team player within our department, many of his patients comment on his
fantastic abilities.



What Exactly ARE Cataracts?
guess a sensible starting point is to assume that if you are
reading this eBook you either have been told you have
cataracts already, or you know someone close to you who has
cataracts and want to know more; or perhaps you know a little
about the condition and think you may have them yourself?

As you probably have heard before the eye is similar in many
ways to a camera.

Light comes in the front, passes through a lens where it is
focused to a sharp image on the light sensitive layer at the back. In
the camera this layer is either a piece of film or an electronic
sensor in a modern digital camera. In the eye this layer is called
the Retina.

As you might imagine, the lens has to be perfectly clear to allow
light to pass through it. But when people have cataracts, the lens is
no longer perfectly clear but gradually becomes milky white in
colour.
This means that the light is no longer focused to a sharp image
on the back of the eye but become blurred as some of the light is
scattered.



The diagrams above show what happens to the light coming into
the eye when the lens becomes cloudy.

A cataract is simply a cloudy lens in the eye.

I




The pictures above compare the images someone without a
cataract might see on the left with the image a person with
cataracts would see on the right.




What are the Symptoms of Cataracts?
rom the above explanation you can see now why cataracts
cause some of the symptoms that they do:
In my clinics, patients with cataracts often complain of
the following problems with their vision:

Difficulty in seeing particularly when driving at night
Halos around bright lights such as street lights
A washed out look to colours
Getting dazzled by the lights of oncoming traffic
Eyes getting tired more easily
Constantly feeling as if you need new glasses

It is important to remember though that not all people with
cataracts have these symptoms. And not all people with these
symptoms have cataracts, as other conditions of the eye can cause
similar problems. Some of these other conditions can be serious,
which is why it is so important to see a specialist if you have
noticed any problems with your eyes.

The other thing is that cataracts do not simply appear overnight.
All cataracts, however they are caused, grow slowly and so the
symptoms they cause appear only slowly too. In fact people often
dont realise they have cataracts at all. They only find out when
they get their eyes checked at an optician because they think that
they need new glasses.

Finally, remember that because cataracts grow slowly, so the
problems with your eyesight that they cause creep up on you
slowly too often so slowly that you may not even notice them. I
have seen many patients who have not realised they had cataracts
at all and it has only been after I have treated them by taking out
the old cloudy lens that they notice how dramatically their vision
improves.


F


What Causes Cataracts?

ataracts are extremely common in fact we probably all
know at least one or two people who have had them
treated. But what causes them exactly?

The commonest cause of cataracts I see in patients is age-
related degeneration of the lens in the eye. There are three causes
of this Nuclear sclerosis, Cortical cataract and posterior
subcapsular opacification. The details of these are not important,
but what is important is that with time all these problems will mean
patients progressively lose their vision and that can be very
disabling and distressing. Poor vision can mean people lose
confidence in getting out and about in unfamiliar places and stay
indoors. Poor vision can mean people socialise less and become
withdrawn. And poor vision makes us more likely to fall or injure
ourselves in other ways.

That is why I find treating cataract so rewarding: because a
simple procedure can give people a whole new lease of life, and
the magic of seeing someones face after their cataract operation
when they can suddenly see clearly again never fades.




The normal human eye
C




The eye of a patient with a cataract

There are many risk factors for developing cataract. J ust some of
these are listed below:

Diabetes
Smoking
Uveitis (inflammation of the middle layer of the eye, the
Uvea)
Excess alcohol intake
More common in women
Steroid medication
Injury to the eye
Ultraviolet light exposure

These are some of the conditions that pre-dispose to developing
a cataract with age in other words, even if you have diabetes you
wont necessarily develop a cataract but on the other hand, if you
are a diabetic, the longer you have been a diabetic, and if the
diabetes hasnt been well controlled, then you are more likely to go
on to develop a cataract.

Not only can cataracts develop with age and in association with
certain medical problems like those above, some people can be
born with cataracts (congenital cataracts) or develop them at a


young age. Causes of cataracts in younger patients include:

Congenital (genetic problems such as galactosaemia)
Developmental problems
Acquired problems (trauma, diabetes, after radiotherapy)
Infections after birth (such as toxoplasmosis)
Infections before birth (such as Rubella, Cytomegalovirus,
Herpes simplex)

These are just some of the causes of cataracts in both adults
and children there are many more that I havent mentioned here.
The important thing to remember though is that the commonest
cause of cataracts is simply changes in the lens of the eye caused
by aging and because there are so many older people in Britain
today than before there are an awful lot of people with cataracts
that need treating.



How are cataracts treated?

he good news is that cataracts are usually very easily
treated.

The bad news is that no change in diet, exercise or pills will
make the slightest difference: the only effective treatment for
cataracts is surgery.

Yet the operation to treat the cataract, in the hands of an expert
is very safe, simple and quick: each eye can take only 20-25
minutes to treat, and the results last a lifetime.

Treatment starts with being assessed by a fully trained eye
surgeon.

I always see my patients personally and go through their medical
history and the symptoms they have been experiencing.

I will then examine your eyes thoroughly to make sure that your
eyes are healthy and to find out exactly where the problem lies.

This is critically important: There are very many causes for
changes in vision and to find out exactly what is the cause in each
case requires an expert with many years of training behind him to
be sure of the diagnosis.

If indeed you do have cataracts we will then decide what to do:
you do not have to have them treated, and if your symptoms are
mild you might decide to leave them alone for a while.

In the past we used to leave cataracts until they became 'mature'
and your vision was really quite poor, but with modern techniques
and advances we no longer do this.

If your cataracts are affecting your vision enough to interfere with
your daily living and your ability to do the things you enjoy then you
will probably want them to be treated.
T


What can I expect during cataract surgery?

fter our initial consultation, if you want your cataracts
treated I will arrange a time for you to come in to the
hospital at your convenience.

This can usually be done within a week or so of our first
consultation, so there is no big delay once you decide you want to
be treated.



Putting local anaesthetic drops in the eye

Most patients can have their cataracts treated under a local
anaesthetic and do not need to be 'put to sleep' for the operation.



Removing the cataract from the eye
Under the microscope I make a tiny nick in the eye and remove the
A


old lens before replacing it with a crystal clear silicon lens.

I make the eye numb by putting an anaesthetic drops in the eye or
something with an infusion of anaesthetic solution around the eye.
I don't use sharp needles and the operation is quite painless.
If you are very anxious I might give a sedative to help you relax, or I
can involve an anaesthetic colleague who will put you to sleep for the
procedure if you prefer.
I make the eye numb by putting an anaesthetic drops in the eye
or something with an infusion of anaesthetic solution around the
eye.

I don't use sharp needles and the operation is quite painless.

If you are very anxious I might give a sedative to help you relax,
or I can involve an anaesthetic colleague who will put you to sleep
for the procedure if you prefer.

During surgery you will feel no pain and see no instruments near
the eye. You may see bright lights or rainbow colours but that is all.

Under the microscope, I will make a nick in the eye and pass a
tiny instrument into the lens to break it up. This is called
'phacoemulsification' and allows me to remove the old cloudy lens.





Removing the old cloudy lens



Implanting the new lens clear vision again at last!

The whole procedure takes maybe 20 minutes on average.
I give all my patients antibiotic drops and anti-inflammatory medicine
for 3 weeks after surgery whilst the eye heals.
Most people go home the same day of surgery



What happens after my operation?

or most people the improvement in eyesight is astonishing
and immediate.
Right away you will notice your vision is much brighter and
clearer, and your vision will continue to improve over the next week or
so.
It is normal to feel some itching or discomfort for 2 or 3 days, after
which even that should settle down.
You will be able to carry on with your normal day-to-day activities
as usual and I will see you about a week or so after your operation
to see how you are getting on.

I will also give you contact details so you can get in touch with
me right away if you have any concerns in the meantime.

F


Are there any risks to cataract surgery?

ataract surgery has been around for very many years now
and with modern surgical techniques is very safe.

It is the commonest eye operation we do and many thousands
are done every year.

Yet no operation or procedure is risk free of course, and one of
the complications we want to avoid is infection which is why I
always give my patients antibiotic eye drops after surgery.

Another condition to be aware of much later down the line is
Posterior Capsule Opacification or PCO. Maybe 20% or a fifth of
people get this over time.

This is a condition whereby the little bag the new lens sits in (this
is the bag the old lens originally sat in too) thickens, leading to a
gradual deterioration in eyesight again.

However with follow-up this condition is easily picked up and can
be effectively treated with outpatient laser therapy.

C


Frequently Asked Questions

Will I need glasses after cataract surgery?

The aim of cataract surgery is to restore your vision, but because
I carefully choose a lens specific to your eyesight when I replace
your old cloudy lens you may find that you do not need glasses at
all, or can use less powerful ones. You are likely to still need
reading glasses though.

What if I have cataracts in both eyes? Will you treat them both
at the same time?

It is not a good idea to operate on both eyes at the same time, so
what I do is treat the cataract in the worst eye first then maybe 3
weeks later treat the remaining eye.

However, what I do is treat the worst eye first, and then three
weeks later after that has fully healed treat the other eye if
necessary.

Is surgery the only treatment for cataracts?

Yes. No other treatments are effective Im afraid.

What will happen if I leave my cataracts?

By the time you are diagnosed with cataracts you will likely have
had the problem for many months, even years before noticing it. If
you leave your cataracts untreated your vision will gradually get
worse and affect your day-to-day life more.

However you will not harm you if you prefer to wait for longer
before getting them treated.

If you take out my cataract do you put anything in its place?

Yes, I will replace the old, cloudy lens with a new, water-clear


implant tailor-made for you.

How long does the new lens last for? Will it need replacing?

The new lens lasts a lifetime and does not need to be replaced
again.

Is cataract surgery safe?

Yes, very safe. However, like all operations it does have risks
that go with it - nothing is absolutely risk free.

Will the operation hurt?

No. The procedure is quite painless.

I don't like the idea of injections in my eye at all.

That is perfectly understandable of course. In almost all cases I
can perform your surgery quite painlessly using eye drops alone.

How long does the operation take?

About 20 - 25 minutes.



Afterword

As you will probably have realized this has been a whistle-stop
summary of information about cataracts what they are, what causes
them and how they are treated. I have also summarized what you can
expect if you should need treatment for cataracts and the common
questions I get asked by patients. I hope it has been useful.

As a consultant ophthalmologist I am fully trained in the
management of all conditions affecting the eye, including the
treatment of cataracts.

If you have problems with your eyes and would like to see me via
the NHS then have a word with your GP and ask to be referred.

If you wish to be seen privately then you do not need a GP referral
and can simply contact my secretary directly.

I look forward to seeing you.

Best wishes,



Mr. J aheed Khan FRCOphth






How to Contact Mr. J aheed Khan
rivately I practice at both Moorfields and at Harley Street
either telephone or send my secretary an email. A GP referral
is not necessary for Private Patients.

Moorfields Eye Hospital



Private Consulting Rooms
J ohn Saunders Suite
9-11 Bath Street
London EC1V 9LF

Tel: (020) 7566 2803

enquiries@moorfields-private.co.uk











View Larger Map
P




Clinica London
140 Harley Street
London W1G 7LB

Tel: (020) 7935 7990
secretary@clinicalondon.co.uk

View Larger Map